North London mental health partnership
A case study on the North London Hub.
The North London Hub was led by UCL and coordinated by the PsychUP for Wellbeing programme, based in the UCL academic clinical psychology department. The Hub partners were Imperial College London, Students’ Union UCL, Imperial College Union, iCope talking therapies service (Camden and Islington NHS Foundation Trust), Ridgmount GP Practice and Imperial College Health Centre.
What was delivered
UCL: University-NHS liaison group
The NHS-Integration Operational Group (NHS-IOG) brought together practitioners from the whole university (including student services and academic departments), from various NHS services, and from student organisations and groups (including Students’ Union UCL), reflecting the variety of support available to UCL students. The group meets quarterly, and there is a standing agenda item at each meeting for a presentation on student research into student mental health.
UCL: Developing the Steps Model in collaboration with students
The UCL Steps Model is a framework for organising mental health support for all students who need it. The model titrates support to need, reflects the developmental needs of students, and facilitates cross-sector partnerships by bringing together elements of the NICE-recommended stepped-care model used in NHS adult services with the iThrive framework for young people.
The IMPACTS (IMProving Access to Treatment and Support) peer research project enabled BSc and MSc psychology students to design and conduct their own research projects, focussing on a student group of their choice. All projects looked at barriers and facilitators to students seeking support, and their experience of care when they do access support, investigated through interviews and thematic analysis of interview transcripts.
Student members of the PsychUP for Wellbeing Advisory Board, who make up the Research and Evidence Working Group, reviewed the IMPACTS peer research projects to identify themes to incorporate into the revised version of the UCL Steps Model. Additionally, findings from the IMPACTS projects have been fed back to university and NHS staff at the NHS-IOG and have informed the peer support pilot.
UCL: University Research Clinic
The University Clinic was set up to provide NHS mental health care for students on campus. The service brings together clinical academic staff and NHS-funded trainee clinical psychologists, enabling students to access evidence-based treatment within a university setting, streamlining referrals while providing clinical trainees with a high-quality placement experience.
Clinical Psychologists and Trainees on placement provided iCope (IAPT) treatments for anxiety disorders and depression to students both face to face (prior to the onset of the pandemic) and latterly online. This included a programme of IAPT workshops adapted for the student population. The clinic has and will continue to develop, offering new types of support, some of which were not previously available to students at UCL. Linked with the academic clinical psychology department, the clinic benefits from clinical academic research and training expertise.
UCL: Workshop and peer support collaboration with Students’ Union UCL
A common theme identified by a number of IMPACTS projects is that students wanted more access to peer support and trusted their peers’ advice about accessing services. At the start of the pandemic lockdown, Students’ Union UCL became concerned about an increased need for support coupled with the fact many students prefer to seek help via the Students’ Union than through services.
PsychUP for Wellbeing and Students’ Union UCL collaborated to develop and pilot an initiative where ‘Peer Link Workers’ are trained to advise their fellow students about how to access mental health support. Ten student Peer Link Workers were trained in essential core knowledge, relational and supportive skills, and information about services available to students. This training was informed by the UCL Partners competence framework for student peer support workers commissioned by Health Education England. Support has been offered on a one-to-one basis or in groups, and around 80 students have been supported under the initiative since June 2021. Peer supporters receive ongoing regular consultative support from Students' Union UCL and local NHS Psychological Services.
Imperial College London: Map staff understanding of services and pathways
The Student Access to Mental Health Support (SAMHS) project mapped out the understandings of university staff in relation to both internal (university) and external (NHS and third sector) mental health pathways. In addition, the perspective of NHS staff on university pathways was sought. A teaching department was used as the focus of the project and a variety of staff, including those with and without a formal welfare component to their role, were interviewed. The project found that:
- Mental health understandings vary significantly across the department
- Student mental health pervades all staff roles, although staff vary as to what degree they feel they need to respond and in what way
- University-based staff do not have a clear picture of services and pathways outside of the university
A regular NHS-university forum has been established at which students of concern can be discussed. The information is being used to develop guidance for staff which will aim to demystify the mental health pathways to which they can direct students in need.
Co-production has been central to the work of the North London Hub, with more than 110 students having input into the work at varying levels. This is in addition to the 100 student participants whose experiences informed the IMPACTS project and revised Steps Model.
More than 90 students contributed to consultation opportunities for students to share their perspectives, experiences and concerns to inform the project. This included supporting the University Clinic work and the development of new initiatives, such as peer support.
Students have taken active roles in the project and participated in defined activities. Sixteen IMPACTS peer researchers helped to gain a better understanding of the barriers and facilitators to seeking support for a range of demographic groups, mental health issues and experiences within the student population. Five Student Fellows led on a student consultation project and contributed to the work with Sheffield. Ten Peer Link Workers were employed by Students’ Union UCL to deliver the peer support pilot project.
Where possible, students were compensated for their time. For one-off engagement this was usually a voucher. Where students took a defined role within the project, they were paid an hourly rate at least equal to or above the London Living Wage. IMPACTS Peer Researchers and PhD students, who were undertaking research as part of their programme of study, were not paid, although funding was provided to cover co-production and other project costs.
Accessing the resources of the academic clinical psychology department, to enhance mental health support
Academic clinical psychology departments have important resources, including expertise in research and evaluation, evidence-based care and pathway development; links with NHS services; and staff and clinical trainees who can be deployed to provide high quality mental health care. The project has facilitated closer collaboration with colleagues from across the whole university, in particular Students’ Union UCL and Student Support and Wellbeing.
Closer collaboration between the NHS and University services
The establishment of the UCL University Clinic has led to greater collaboration between NHS and university services, including the provision of services not previously available to UCL students (the new club drug/ addictions clinic). Where services, such as IAPT, have been available and accessible previously, there is more collaboration (such as the involvement of IAPT with the Students’ Union peer support pilot) and improved communication (such as the inclusion of the category of ‘student’ to referral details within IAPT).
Development of the Steps Model and building the evidence base for different needs-based care pathways
The IMPACTS research projects provide rich data about the experiences of a diverse range of student groups. Our student Advisory Board Research and Evidence Working Group have worked with the team to review and incorporate findings into the revised Steps framework, a significant piece of work which has strengthened the model.